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Detecting Lung Cancer Early

New Methods, Decades in the Making, Find Lung Cancer When it Can Still Be Cured

By the time you feel the symptoms of lung cancer, it’s probably already inoperable. Only 15 percent of patients survive five years after being diagnosed with lung cancer, and 60 percent of newly diagnosed lung cancer patients will die within a year. But lung cancer is eminently treatable if it is caught early. Survival rates climb dramatically with early diagnosis, to around 80 percent for localized, stage I cancers.

James Jett, MD, has devoted much of his career to finding ways to reduce the terrible toll of lung cancer by screening large numbers of people to detect lung cancer early in many of them. Dr. Jett, an internationally recognized expert in lung-cancer screening, joined National Jewish Health in early 2011.

Tricky Problem
Screening for lung cancer is a tricky problem. Advanced imaging may detect tiny cancers before they cause symptoms. But the vast majority of people undergoing such a screening test would get no benefit because they do not have cancer. Some images show an abnormality that subsequently proves benign, a false-positive test, leading to unnecessary anxiety and diagnostic procedures that could cause harm and even death.

“Finding the balance between the potential life-saving benefits of early detection and the social and personal costs of false-positive tests has been a tremendous challenge,” said Dr. Jett. “Many thought there would never be an effective screening test for lung cancer.”

Never Gave Up
But Dr. Jett and other researchers at National Jewish Health never gave up. This year an international team of researchers that included Dr. Jett and National Jewish Health radiologist David Lynch, MD, reported the results of the National Lung Screening Trial: low-dose CT scans offered yearly for 3 years to heavy smokers at high risk for lung cancer decreased mortality by 20 percent, compared to screening with chest x-rays.

“This research is very exciting. It is the single most important decrease in lung-cancer mortality reported to date,” said Dr. Jett. “We have now shown that CT screening can be an effective tool to detect lung cancer early when more curative treatment options are available.”

Although the scientific findings were promising, there is an ongoing debate about the wide-scale use of these tests to detect cancer, informed by economics and cost-benefit analyses as well as compassion. Dr. Jett believes that, for carefully selected high-risk individuals, the low-dose CT chest scan can be a life-saver, and recommends it to them.

Many National Jewish Health patients fall into that high-risk pool, and National Jewish Health recently launched a lung cancer screening program for them.

Improved Screening
In addition, Drs. Jett, Lynch, and others are working hard to improve lung-cancer screening. The National Jewish Health Cancer Center is working closely with the Institute for Advanced Biomedical Imaging® to develop methods to more accurately predict whether small nodules in the lungs are likely to be cancer. Dr. Jett is also seeking to refine the screening process by identifying novel lung-cancer biomarkers in the blood that could be combined with results from CT scans to more accurately diagnose early lung cancer.

“We are going to continue to look for advances that will detect lung cancer as early as possible,” said Dr. Jett. “I am as optimistic as I’ve ever been about our potential to detect early stage lung cancer and decrease the number of patients dying of this dreaded disease.”